Greetings, Dear Readers, and welcome back to the Lighthouse InSight series!  This month we’re celebrating our second installment by taking it all the way back… all the way back in the alphabet that is. Because A is for Arthroscopy.

Arthroscopy is a minimally invasive procedure that allows a surgeon or clinician to view inside our joints using an aptly named arthroscope. It’s commonly used to investigate, diagnose, and even treat damage, wear & tear, and other conditions. The origins of arthroscopy can be traced all the way back to the late 19th century, however the modern implementation and widespread usage really came about in the 1970-80’s[1].  Since then, arthroscopy has become the most common type of orthopedic surgery [2].  So there’s a very good chance that any of us will undergo some form of arthroscopic procedure due to a sports injury, arthritis, aging, or a variety of other common ailments.

I know, you’re now asking ‘why is arthroscopy so common and what are the benefits?’, and thank you for the perfect segue!  Arthroscopy has largely replaced fully open surgery for routine examinations and diagnoses of joint ailments. There are even many procedures that can be done arthroscopically, such as removal of debris or loose, torn, and damaged tissue.  There is a clear advantage to the much smaller incision (often called keyhole incision) as compared to a fully open surgery, as evidenced by less pain, quicker recovery, and reduced rates of infection [3].  (It should be noted that, while this advantage holds true for diagnostic purposes, there are indications that some arthroscopic interventional procedures may not provide long term benefits [4].)

Just as it went through a revolution some 40 years ago, we are in the midst of a new era of arthroscopy.  Traditionally, arthroscopes were constructed using two primary methods. A rigid, rod lens based scope offered the best image quality, but was limited to sizes of approximately 2.8mm in diameter and larger.  Fiberscope based systems were able to be flexed and can be produced in very small sizes, but suffer from inferior image quality. Both types of arthroscopes could then be coupled to a standard endoscopic camera system to be displayed on a monitor for visualization [5].

Fast forward to the 21st century, where image sensors are small.  Ney, make that tiny. This gives us the ability to put the image sensor and optics right at the distal tip of an arthroscope, reducing complexity and cost, while allowing for flexibility and improved image quality at size.  As with traditional scopes, there are always size vs. performance trade-offs, however the bar has been raised significantly and is expected to do so for the foreseeable future.

The current trends for arthroscopy involve more than size and performance improvements.  For example, a push for true office based arthroscopy is underway. Changing the procedure workflow is an ambitious undertaking, but can result in quicker and more cost effective diagnosis [6].  The equipment to support such an application tends to be smaller, portable, more affordable,  and user friendly to cater to the needs of an in-office procedure. While sterilization and reprocessing is a practical concern in this environment, a trend towards single-use devices and sterile barrier prophylactics has abated much of the challenge.

Lighthouse Imaging is on the forefront of advancements in arthroscopy and medical visualization, and we are passionate about enabling our clients to deliver world-class medical devices.  Through our turnkey solutions for medical optics and visualization, we strive to make the world a better, healthier place.  I am quite fortunate to be able to share my excitement and enthusiasm daily with the amazingly talented team here at Lighthouse Imaging; a world-leading provider of custom OEM solutions and contract manufacturing.  Do you have any questions or comments about this topic? I’d love to hear from you.

Be kind and see you next time…

Benjamin J. Gray

CTO – Lighthouse Imaging